Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | PT21173 | FL |
N | 2251X0800X | Physical Therapist - Orthopedic | PT21173 | FL |
NPI | 1134360589 |
---|---|
Provider Name | Ms. Sharon Betty Tarquinio |
First Address | Fort Myers, FL 33913-7829 |
Second Address | Fort Myers, FL 33901-4900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2009 |
Last Update Date | 03/08/2010 |